Clinical Experience in 200 Renal Transplants at Catholic Medical Center

Between March, 1969, and April, 1986, two hundred of renal allograft recipients were treated with either cyclosporine (CsA) + prednisone (n=53) or azathioprine (Aza) + prednisone (n = 147). On October 31, 1986, the actuarial patient survival rate at two years was 75% for all patient group. The corresponding graft survival rate at two years was 68 % for all patients. The actuarial patient survival rate at two years was 71% in the Aza group, and 94% in the CsA group including recipients converted from CsA to Aza (3 cases), which was statistically significant (p<.001), and the corresponding graft survival rate was 65% and 80%: the difference was not statistically significant. In the CsA-treated group, excluding converter from CsA to Aza (3 cases), however, the graft survival rate at two years was 91%, which was statistically significant (p = .0056). There was no significant difference of graft survival rate between the recipients who received DST vs non-DST in CsA-treated group. It was difficult to evaluate the recipients who were given DST due to a small number of cases and short follow-up period. In either, the Aza-or the CsA-treated group, the graft survival rates were higher in HLA identical LRD group than in either haplo-identical or mismatched LRD group. Total of 63 patients, who received kidney transplantation expired. The most frequent cause of death in 17.5% of cases was uremia per se due to graft failure, followed by infection (14.7%), vascular (14.3%), and cardiac (11.1%). The most commonly encountered posttransplant complications in order of frequency were as follows: erythrocytosis (18.0%), pneumonia (15.0%), urinary tract infections (14.0%), herpetic infections (12.0%), fungal infection (11.5%), posttransplant diabetes (8.5%), technical (5.0%) and others.